Members of Household
Providing this information should speed the processing of your claim. Income reported here should not be included on line 10 of this form.
13. Enter in the spaces provided the annual amount of all other income not included as household income on line 10:
(a) Food Stamps
(b) Nongovernmental Gifts
(c) Child Support
(d) Settlements (lump sum)
(e) Personal and Student Loans
(f) SSI, Social Security, Veterans or Railroad
Disability (enclose documentation)
14. List the names of ALL persons who resided in your household at any time during 2020. Specify the number of months they lived with you and
report their portion of income that is included in total household income on line 10 of this form.
Their portion of income that is
included on line 10
Social Security Number
FORM K-40PT LINE-BY-LINE INSTRUCTIONS
If you filed a Form K-40H for 2020, you cannot claim this refund.
NAME AND ADDRESS
Use the instructions for Form K-40H on page 4 to complete the personal
information at the top of Form K-40PT.
Lines 1 through 3: You must have been 65 years of age or older (born
before January 1, 1955), a resident of Kansas all of 2020 and a home
owner during 2020. If you meet these qualications, enter your date of birth
on line 3.
Enter on lines 4 through 8 the annual income amounts received by you and
your spouse during 2020. Enter on line 9 the income of ALL other persons
who lived with you at any time during 2020.
Lines 4 and 5: Use the instructions for lines 4 and 5 of Form K-40H that
begin on page 4 to complete lines 4 and 5 of Form K-40PT.
Line 6: Enter the total Social Security and Supplemental Security Income
(SSI) benets received by you and your spouse. Include amounts deducted
for Medicare, any
Social Security death benets, and any SSI payments not
shown on the annual benet statement. Do not include Social Security
or SSI “disability” payments. (NOTE: Social Security disability or SSI
payments become regular Social Security payments when a recipient reaches
full retirement age. These Social Security disability payments, that were once
Social Security disability or SSI payments, are NOT included in household
income.) Enter the annual amount of any Social Security disability benets
and Social Security payments of a person who has reached full retirement
age who had previously been receiving Social Security disability payments,
in the Excluded Income section on the back of Form K-40PT and enclose a
benet statement or award letter with your claim.
If you do
not have your statement of Social Security benets, use the
method given for line 6 of Form K-40H to compute your total received in
2020. Instructions are on page 4.
Lines 7 through 9: Use the instructions for lines 7 through 9 of Form K-40H
on page 5 to complete these lines on Form K-40PT.
Line 10: Add lines 4 through 9 and enter the result. If line 10 is more than
$20,700, you do not qualify for a refund.
Line 11: Enter the
total 2020 general property tax you paid as shown on
your real estate tax statement. Enter only timely paid tax amounts. For a list of
items that you cannot include see the instructions for line 12 of Form K-40H
on page 5.
If you are ling on behalf of a claimant who died during 2020, the property
tax must be prorated based on the date of death. To determine the property
tax amount to enter here, follow the instructions for deceased claimants on
Line 12: Multiply the amount on line 11 by 75% (.75). This is the amount
of your property tax refund.
Line 13: To speed the processing of your refund, list in items (a) through
(g) all other income that you did not include on line 10. For more information
on what to include here, see Excluded Income on page 6.
Line 14: List all persons who resided in your household at any time during
2020. Complete all requested information for each person. If more space is
needed, enclose a separate sheet.
You, as the claimant, MUST sign the claim. See the instructions for
Signature on page 6.
MAIL TO: Homestead Claim, Kansas Department of Revenue, PO Box 750260, Topeka KS 66699-0260